The Left Atrium important thing, she muses, is to be gra- Gerry’s wig cious and to do the best she can. This My left breast: an unusual film about breast cancer means welcoming the organic produce, Gerry Rogers, director; Peggy Norman, camera; herbal potions and (to her mother’s Paul Pope, producer consternation) packages of marijuana St. John’s, Newfoundland: Pope Productions, Ltd; 2000 people give her. It also means submit- 57 min. $24.95; institutions: $99.95 plus tax and shipping ting to modern medicine’s more brutal ISBN 096880820-4 Available: www.myleftbreast.com means. Disfiguring surgery, the infusion of “the red devil” in her veins, skin erry Rogers looks at the camera visits to her doctor. Although centred on scalded by radiation: Who can embrace G through the two zeros in the self-disclosure, this is an an extremely these as an experience of healing? This is middle of her zany millennium sun- helpful film, one that posits a viewer the most difficult thing: to face unpleas- glasses and asks, “Should we talk about faced with a similar situation herself. ant treatments with feelings of deep am- the year 2000?” The question is ad- This creative outlet, the film, docu- bivalence. Gerry worries about this: To dressed to her lover, companion, care- ments another: the collective project, get better, should she not always be giver and camerawoman, as well as to guided by a professional wigmaker, of thinking positive thoughts? the viewer of this intimate autodocu- making a “healing wig.” Gerry asks mentary, my left breast. Behind the friends, family, neighbours, the women camera, the voice of Peggy Norman is behind the post office counter, every- sceptical: “What is there to say about one she knows, for a lock of hair. The it?” she asks. “Hopefully,” Gerry an- idea catches on. Offerings arrive by swers, “the year 2000 will be better mail from across the country. Samples than the year 1999 for us, although I from entire families, including cats and still think we were really lucky.” dogs. A carefully packaged and labelled Gerry Rogers’ luck fizzled rather collection from the childen at a school badly in 1999, the year she and her part- for the deaf. Thick tresses kept in a ner started a bed and breakfast business drawer for 30 years. The hair that a in Carbonear, Newfoundland, and then women had cut off the year she herself Courtesy Pope Productions discovered Gerry had breast cancer. started chemotherapy. It’s a complex Gerry started making this film the day impulse to preserve a lock of hair: a The quiet triumph of this 60-minute her hair began to fall out during hedge against loss, a nostalgic gesture, film is that it convinces us that Gerry chemotherapy. It was, to use Peggy’s an act of hope, a memento mori. These Rogers is lucky. She has a deep respect word, an “outlet” for her feelings. In the very personal artifacts are given as a for herself and others, a buoyant sense small hours of sleepless nights Gerry benediction, a wish for Gerry’s restora- of humour, a gift for communication points the camera at a mirror and talks tion, an expression of solidarity. and community building. She knows about her fears, her sense of isolation, Gerry inspires generosity, first be- what she needs and asks for it. She her feelings of loss. She shows us how cause she is so likeable, and second be- shares, unasssumingly, what she learns. her hair comes out in tufts, the incision cause she so clearly values the love and Giving and receiving, she achieves an left after modified radical mastectomy, support she receives. She confides to the amazing grace. the flushing of her Hickman catheter. camera that “love and tenderness are so She takes us to her chemotherapy and important to me right now.” Metaphors Anne Marie Todkill Courtesy Pope Productions radiotherapy sessions and to follow-up of battle don’t really interest her; the CMAJ Room for a view The gravedigger’s bed hen I was a junior intern in Many people had private insurance, but mitted to the public teaching hospitals. WMontreal, we had no problems this covered only acute care and usually The justification was that the diagnosis with beds being blocked by patients with terminated after two weeks in hospital. was obvious, and there was no treatment chronic conditions, at least not in teach- But there were other means of pre- that could not be given elsewhere. ing hospitals. One of the reasons for this venting bed-blocking. There was a rule, When we were on call we might be tele- was simple: at that time there was no na- for instance, that people with stroke, phoned in the middle of the night by a tional or provincial health insurance. even of recent origin, could not be ad- harried general practitioner with a stroke 672 JAMC • 6 MARS 2001; 164 (5) The Left Atrium patient, but we were adamant: disposal ferred to one or the other mental hos- of this patient was his problem, not ours. pital, depending on his religion and Putting in time On one occasion, however, a soft- language. hearted staff physician did admit an el- Some time later I spent several years until the party is over derly man, a gravedigger by trade, who’d in Britain, where the recently estab- Alone in a corner she sits had a stroke and had no one to care for lished National Health Service was un- hands folded him. Since he could not be admitted to a dertaking to provide treatment for all patiently waiting. teaching bed, he was admitted to the pri- persons “from womb to tomb” or, as vate pavilion. Very quickly it was real- we jokingly said, “from erection to res- Belle of the ball, ized that, financially, he was utterly ineli- urrection.” There I met the remarkable bathing queen, gible for this privilege, and he was Dr. Marjory Warren, who had shown no longer aware, transferred to a public (that is, teaching in the 1930s that with accurate diagno- she needs hospital) bed. The next morning we sis and simple rehabilitation many a diaper change. found him breathing stertorously. He chronically disabled patients could was unconscious. When we made ward leave institutional care. Her appoint- Robert C. Dickson rounds, the physician in charge ex- ment was at a large county hospital Family physician pressed indignation and ordered the pa- with a workhouse attached. She was Hamilton, Ont. tient to be discharged. This meant call- able to discharge some people to jobs, ing on the social worker to find a some to sheltered housing and some to nursing home bed. She was able to com- their own homes. The workhouse was over which the prayers and religious ply at once, as she had a working rela- converted into a general hospital, which services of the nuns were broadcast. tionship with several nursing homes. included a 180-bed geriatric unit. Here There were no magazines or radios. They called her when they had an empty she treated her own patients as well as I proposed to the nuns that I could bed, and she undertook to fill them. So those transferred from other hospital organize a rehabilitation program and by mid-morning the stroke patient was wards. Because the other physicians had encourage activities. They gave my of- gone. We didn’t know where, nor did nothing further to contribute to their fer careful consideration for a few days we care. I realized later that, as there patients, they considered such transfers and then declined it. They quietly ex- was no treatment or rehabilitation in as “clearing their beds,” a kind of social plained that these patients had not long nursing homes, the patients sent there work, and referred to Dr. Warren as to live and should profit from their re- quickly developed bed sores and aspira- Miss Warren. maining time by preparing for eternity. tion pneumonia and died. The turnover When I returned to Canada I started Moreover, if their own physicians had of cases was quick and efficient. practice as a geriatrician. Very soon, el- not ordered rehabilitation, it was prob- On another occasion, a patient on derly patients were referred to me by lo- ably not needed. the ward became confused, noisy and cal practitioners. Unfortunately, I In a town nearby was a home for violent, unsuitable for a nursing home. quickly discovered that these patients English-speaking elderly people. I spoke We decided he should go to a mental were referred when their hospital insur- to the physician in charge about the hospital. There were two: the Verdun ance had run out and possible need for Protestant hospital with 1500 beds, and they had to be dis- diagnosis and med- St. Jean de Dieu with 5000. But these charged. They could ical care, especially hospitals were always full. In the days not afford to pay me. as on the day of my before effective therapy they housed Although there was a visit a resident of many young schizophrenic patients small rehabilitation the home had just who were there for life. Indeed, their department at the died of heart fail- parents were encouraged to consider hospital, I explored ure because no one them deceased and to put a death no- the possibility of had reordered her tice in the newspaper. There were also longer-term treat- diuretic medica- severely manic or depressed patients ment at a large Art Explosion tion. He agreed to and some with dementias arising from chronic care hospital speak to the board syphilis or Alzheimer’s disease.